All patients can gain from these developments. Siemens’s new wide-bore Magnetom Espree-Pink breast scanner, for example, allows spectroscopy and biopsies to be carried out in situ, aided by dedicated software and a specially designed coil (see ‘How MRI works’ p22) that can be adjusted to optimise scanning of any breast size.
Don’t take it lying down
Some conditions, like certain back injuries, can actually be made worse by patients lying flat on their backs in a conventional scanner. In open scanners they don’t have to.
At the Nuffield Orthopaedic Centre (NOC) in Oxford, where they installed a FONAR 360° open scanner in a purpose-built building in 2006, they can now scan patients lying on their sides. Their scanner also accommodates larger patients and has seen the number of people requiring pre-scan sedation fall from roughly one a week (when using a conventional scanner) to one every two months, says Ruth McDonnell, MRI lead radiographer at the NOC.
“Patients are often relieved to find the scanner is not a tube like they’ve seen on TV. Being able to see out of the scanner throughout the examination makes them feel much less enclosed,” explains McDonnell. Philips’s patient studies echo this experience: their Panorama HFO open scanner reduced the rejection rate by claustrophobic patients by a half.
Systems like the FONAR UPRIGHT multi-position scanner take the idea a stage further. “It can scan patients upright in weight-bearing positions, in positions of pain, and in positions of flexion, extension, lateral bending and rotation,” says a spokesperson for US-based FONAR. Patients can also be scanned sitting upright or lying horizontally. This provides a new route to diagnoses for doctors and physiotherapists, and is particularly valuable for spinal problems that can look significantly different when lying down.